文章摘要
孙 潞,崔晓光,李 媛,杨克丰,王文松.下肢肌肉状态与老年患者衰弱状态的相关性初步研究[J].,2024,(17):3289-3293
下肢肌肉状态与老年患者衰弱状态的相关性初步研究
A Preliminary Study of the Correlation between Lower Limb Muscle Status and the Frailty State of Elderly Patients
投稿时间:2024-03-22  修订日期:2024-04-18
DOI:10.13241/j.cnki.pmb.2024.17.018
中文关键词: 衰弱  老年患者  下肢肌肉  超声
英文关键词: Frailty  Elderly patients  Lower limb muscles  Ultrasound
基金项目:国家自然科学基金项目(82160306-H1105)
作者单位E-mail
孙 潞 海南医学院第一附属医院麻醉科 海南 海口 570102 3222036597@qq.com 
崔晓光 海南医学院第一附属医院麻醉科 海南 海口 570102  
李 媛 海南医学院第一附属医院麻醉科 海南 海口 570102  
杨克丰 海南医学院第一附属医院超声科 海南 海口 570102  
王文松 海南医学院第一附属医院麻醉科 海南 海口 570102  
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中文摘要:
      摘要 目的:分析老年男性患者下肢肌肉状态与衰弱的相关性。方法:选取行前列腺电切除手术的老年男性患者50例,利用Fried量表评估患者衰弱程度,根据评估结果,将患者分为两组,衰弱组23例,非衰弱组27例。利用超声测量优势下肢股直肌厚度及横截面积、腓肠肌内侧头羽状角,并记录一般资料、实验室检查及围术期相关资料,通过单因素和多因素logistic回归分析与衰弱的相关变量。结果:与非衰弱组相比,衰弱组患者的年龄更大、BMI更低、股直肌厚度更小、腓肠肌内侧头羽状角更小、白蛋白和血红蛋白更低,术中出血量更多、使用血管活性药物越多,术后住院时长更长。单因素logistic回归分析显示,年龄>70岁(OR=5.667)、BMI(OR=0.578)、股直肌厚度(OR=0.035)、腓肠肌内侧头羽状角(OR=0.399)、血红蛋白(OR=0.944)、白蛋白(OR=0.853)、住院时长(OR=1.265)、出血量(OR=1.111)与衰弱状态相关;多因素logistics回归分析显示腓肠肌内侧头羽状角和BMI对衰弱状态能够作为老年男性患者衰弱的预测指标,其ROC曲线下面积为0. 880,敏感性和特异性分别为91.30%和74.07%。结论:老年男性患者年龄、BMI、股直肌厚度、腓肠肌内侧头羽状角、血红蛋白、白蛋白、住院时长、出血量与衰弱具有相关性。腓肠肌内侧头羽状角联合BMI,对老年男性患者衰弱状态具有预测价值。
英文摘要:
      ABSTRACT Objective: Analysing the correlation between lower limb muscle status and frailty in elderly male patients. Methods: 50 elderly male patients undergoing transurethral resection of the prostate were selected. The Fried scale was used to evaluate the degree of frailty. According to the evaluation results, the patients were divided into two groups, 23 cases in the frailty group and 27 cases in the non-frailty group. Ultrasound was used to measure the thickness and cross-sectional area of the rectus femoris of the dominant lower limbs, and the feather angle of the medial head of the gastrocnemius muscle. The general data, laboratory examination and perioperative data were recorded. The related variables of frailty were analyzed by univariate and multivariate logistic regression. Results: Compared with the non-frailty group, the frailty group had older age, lower BMI, smaller rectus femoris thickness, smaller medial head of gastrocnemius pinnate angle, lower albumin and hemoglobin, more intraoperative blood loss, more use of vasoactive drugs, and longer postoperative hospital stay. Univariate logistic regression analysis showed that age > 70 years (OR = 5.667), BMI (OR = 0.578), rectus femoris thickness (OR = 0.035), medial head of gastrocnemius pinnate angle (OR = 0.399), hemoglobin (OR = 0.944), albumin (OR = 0.853), length of hospital stay (OR = 1.265), blood loss (OR = 1.111) were associated with frailty. Multivariate logistic regression analysis showed that the feather angle of the medial head of the gastrocnemius muscle and BMI could be used as predictors of frailty in elderly male patients. The area under the ROC curve was 0.880, and the sensitivity and specificity were 91.30 % and 74.07 %, respectively. Conclusion: Age, BMI, rectus femoris thickness, medial head of gastrocnemius feather angle, hemoglobin, albumin, length of hospital stay, and blood loss were associated with frailty in elderly male patients. The feather angle of the medial head of the gastrocnemius muscle combined with BMI has predictive value for frailty in elderly male patients.
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